Monica C. Fuentes

• Assisted with managed care auditing processes and performed internal file audits.
• Tracked expiration dates on documents and communicated with appropriate staff to avoid late filing.
• Worked closely with practitioners to help each obtain privileges at assigned healthcare facilities
• Communicated effectively with various parties each day using polished interpersonal and active listening skills.
• Maintained accurate files, records and credentialing documents in well-maintained databases using Credential Stream and Morrissey.
• Received and evaluated applications to look for missing and inaccurate information.
• Conducted primary source verifications such as background checks and board certifications.
• Improved office efficiency by effectively managing internal communications and correspondence.
• Obtained NPI numbers for providers and facilities and updated existing profiles.
• Prepared records for site visits and file audits.
• Collected and analyzed information to monitor compliance outcomes and identify and address trends of non-compliant behavior.
• Conducted department and sub-department meetings, and meeting minutes.

• Tarzana neurosurgery & pain management, tarzana, Create/Maintain Medical chart
• Consult patients for surgery scheduling
• Review and obtain referrals for PPO, HMO and Medicare
• Schedule surgery with various facilities
• Obtain pre-operative clearances
• Answer incoming calls
• Set patient for pre-op and post-op appointments
• Answer patient’s medical questions regarding surgery scheduling
• Epic Trained
• Expertly managed planning, scheduling and coordination of outpatient procedures.
• Verified insurance coverage and obtained pre-authorizations.

• Create/Maintain Medical chart
• Check vitals
• Stock Medical Supply
• Conduct and organize laboratory testing
• Answer incoming calls
• Set up telemedicine conference for physician
• Set patient appointments
• Answer patient’s medical questions
• Provider credentialing
• Maintain Accounts receivable ledger
• Review claims and Patient Eligibility
• Obtain and review referrals for HMO patients

• Answer phones, assist with claims, appeals, etc
• Assist members with changing PCP, and other issues with eligibility
• Assist lead with providing good accurate information to members and providers
• Help members understand they’re health plan and answer members questions

• Basic Office Housekeeping
• Assist Doctor in retrieving tools, or storing supplies during patient visits
• Answer Incoming Calls
• Assist with patient care, and prescriptions
• Review Authorizations for treatment/ Referrals
• Outbound call to insurance companies for Claims

Medical Assistant